Pneumatic retinopexy for primary retinal detachment

Pneumatic retinopexy (PR) is a minimally invasive surgical technique utilized for the repair of rhegmatogenous retinal detachment (RRD).It is composed of intravitreal gas injection,either cryopexy or laser, and postoperative patient positioning. Historically, the first report of the use of intraocular gas injection for the treatment of RRD appeared in 1911 [1].Rosengren, in 1938, reported the first large series of patients treated with intraocular air injection, drainage of subretinal fluid (SRF), and diathermy [2].The modern PR technique was born in 1985 with simultaneous reports by Hilton and Grizzard in the United States [3] and Dominguez in Spain [4, 5]. The PR procedure appears to be gaining in popularity, although there is considerable variation in its use based on geography and practitioners years in practice. Surveys of American vitreoretinal specialists in 1990 and 1997 revealed an increase in use from 38% to 55% for a given ideal clinical scenario. There was significant variation in the choice of surgical technique based on surgeon age. Those in practice less than 10 years chose PR 65% of the time compared with 35% of those in practice 20 years or more.Within the United States, there was regional variation with 74% of survey respondents in western states choosing PR compared with 43% in north central states [6]. The rise in the popularity of PR may be due to the perceived benefits to the patient, the attending physician, and society as a whole. Well-informed patients typically prefer PR because of itsminimally invasive nature.There is little pain,more rapid return of vision, and fewer postoperative complications, resulting in a more expedient return to daily activities. For the surgeon, the procedure is quick, technically easy, and performed in the outpatient or office setting. These advantages, combined with the procedures low cost, have led to increased interest and usage of PR for the treatment of primary RRD.